Postural Orthostatic Tachycardia Syndrome (POTS) & The Nervous System: A Neurological Approach to Healing
Postural Orthostatic Tachycardia Syndrome (POTS) is a complex disorder of the autonomic nervous system (ANS) characterized by an excessive increase in heart rate upon standing. This condition leads to a myriad of symptoms, including lightheadedness, palpitations, fatigue, and cognitive difficulties, collectively known as "brain fog." Understanding the neurological underpinnings of POTS is crucial for effective management and treatment.
The Autonomic Nervous System and POTS
The ANS regulates involuntary physiological functions such as heart rate, blood pressure, and digestion. It comprises two main branches:
✔ Sympathetic Nervous System (SNS) – Activates the "fight or flight" response, increasing heart rate and blood pressure. ✔ Parasympathetic Nervous System (PNS) – Promotes the "rest and digest" state, slowing the heart rate and facilitating digestion.
In individuals with POTS, there is a dysregulation within these systems, particularly upon transitioning to an upright posture. Normally, standing causes blood to pool in the lower extremities, and the body compensates by constricting blood vessels and increasing heart rate slightly. However, in POTS patients, this compensatory mechanism is exaggerated, leading to an excessive heart rate increase (tachycardia) without a corresponding drop in blood pressure. This suggests a malfunction in the autonomic pathways that control cardiovascular responses to postural changes.
Neurological Mechanisms Behind POTS
Several neurological factors contribute to the pathophysiology of POTS:
✔ Autonomic Neuropathy – Some POTS patients exhibit damage to the small fiber nerves that regulate blood vessel constriction. This leads to blood pooling in the lower extremities upon standing, prompting the heart to compensate by increasing its rate. ✔ Hyperadrenergic State – A subset of patients experience elevated levels of norepinephrine—a neurotransmitter involved in the "fight or flight" response—upon standing. This results in an exaggerated sympathetic response, causing significant tachycardia and other related symptoms. ✔ Central Autonomic Network Dysfunction – The brain regions responsible for integrating and regulating autonomic functions may not function optimally in POTS patients. This central dysregulation can lead to inappropriate cardiovascular responses during postural changes.
Cognitive Impairments: The "Brain Fog" Phenomenon
One of the most debilitating symptoms reported by POTS patients is cognitive impairment, commonly referred to as "brain fog." This encompasses difficulties with attention, memory, and executive function. Research suggests that reduced cerebral blood flow due to autonomic dysregulation may underlie these cognitive challenges. When standing, inadequate blood flow to the brain can impair neuronal function, leading to the observed cognitive deficits.
Potential Autoimmune Links
Emerging evidence indicates that POTS may have an autoimmune component. Some patients possess autoantibodies that target receptors involved in autonomic regulation, such as the adrenergic and muscarinic receptors. These autoantibodies can disrupt normal autonomic signaling, contributing to the symptoms experienced in POTS.
The Chiropractic Approach to POTS: Restoring Nervous System Balance
While conventional treatments focus on symptom management, neurological-based chiropractic care seeks to address the root cause of autonomic dysfunction by enhancing nervous system adaptability and regulation.
✔ Addressing Nervous System Imbalances – Chiropractic adjustments help regulate brainstem function, vagus nerve activity, and autonomic balance, supporting improved adaptation to stress and postural changes. ✔ Improving Vagal Tone – The vagus nerve is a key regulator of autonomic function. Chiropractic care has been shown to enhance parasympathetic activity, reducing sympathetic overdrive and promoting cardiovascular stability. ✔ Supporting Neuroplasticity – Research by Dr. Heidi Haavik has demonstrated that chiropractic adjustments improve brain function and sensory-motor integration, which can support better autonomic control in individuals with POTS. ✔ Reducing Brainstem Tension – Tension and dysfunction at the upper cervical spine and brainstem can contribute to dysautonomia. Adjustments in this area help restore neurological communication, facilitating better heart rate regulation and postural control. ✔ Enhancing Cerebral Blood Flow – Chiropractic adjustments have been shown to improve cerebrovascular function, which may help alleviate the brain fog and cognitive challenges experienced by many POTS patients.
Understanding Subluxation: The 4D Model & Its Role in POTS
In chiropractic, a subluxation is more than a structural misalignment—it represents neurological dysfunction that disrupts communication between the brain and body. The 4D Model of Subluxation describes how this interference occurs:
✔ Dyskinesia – Abnormal movement patterns within the spine and nervous system disrupt the body's ability to regulate posture and cardiovascular function. In POTS patients, this may contribute to autonomic instability upon standing. ✔ Dysafferentation – Altered sensory input from the spine and body to the brain creates faulty neurological feedback loops. In POTS, this means improper regulation of blood flow, heart rate, and autonomic balance. ✔ Dysponesis – Inefficient neurological responses due to an overactive stress response. Many POTS patients exhibit chronic sympathetic dominance, preventing their nervous system from achieving proper parasympathetic recovery. ✔ Dysautonomia – The direct result of nervous system interference, leading to autonomic dysfunction. In POTS, dysautonomia manifests as the inability to regulate heart rate, blood pressure, digestion, and temperature control.
By correcting subluxations through chiropractic adjustments, we restore proper neurological function, allowing the autonomic nervous system to regain balance and adaptability.
Chiropractic: A Vital Piece of the POTS Puzzle
POTS is a multifaceted neurological condition, and while medications and physical therapy can provide symptom relief, they do not address the nervous system imbalances at the core of the disorder.
Chiropractic care offers a unique, non-invasive approach to improving autonomic regulation, vagal function, and overall neurological adaptability—giving individuals with POTS a chance to restore balance and resilience within their nervous system.
At Purpose Driven Chiropractic, we utilize neurological scans, HRV assessments, and advanced chiropractic techniques to evaluate how the nervous system is adapting to stress. By restoring optimal function and reducing nervous system interference, we help individuals with POTS improve their quality of life, autonomic function, and long-term well-being.
📅 If you or a loved one is struggling with POTS, schedule a consultation today to explore how neurological-based chiropractic care may support your recovery and nervous system health.
